The inspection took place on 19 and 20 April 2017 and was unannounced. This meant the provider or staff did not know about our inspection visit.We previously inspected Durham House in February 2015, at which time the service was compliant with all regulatory standards and was rated Good. At this inspection the service remained Good.
Durham House is a care home in Chester-le-Street, Durham, providing accommodation for up to 31 older people who require nursing and personal care. There were 24 people using the service at the time of our inspection.
The service had a registered manager in place and a new manager in post, who was being supported through their probationary period.
Risk management processes were in place and regularly reviewed, such as risk assessments and falls analysis, protecting people against a range of risks.
There were ample staff on duty to meet people’s needs and keep them safe. The provider used a dependency tool to ensure there were always ample staff to meet people’s needs.
The management of medicines was safe and adhered to National Institute for Health and Care Excellence [NICE] guidelines. Where we identified an area that could be improved the provider responded promptly.
The service was clean throughout and the premises effectively maintained.
Staff were trained in safeguarding, health and safety, moving and handling, infection control, mental capacity, dementia awareness and food hygiene. Staff demonstrated a good knowledge of these topics.
There was a consensus of opinion that staff effectively supported and managed people’s healthcare needs through ongoing liaison with external professionals.
All people who used the service we spoke with, relatives and visiting healthcare professionals stated staff demonstrated caring attitudes towards people.
There were patient and compassionate interactions displayed by staff throughout our inspection.
The atmosphere and culture at the service was homely and welcoming.
We checked whether the service was working within the principles of the Mental Capacity Act 2005 (MCA). The manager and staff displayed a good understanding of capacity and we found related assessments had been properly completed. The provider had fulfilled their legal obligations in relation to assessing and arranging requirements in the Deprivation of Liberty Safeguards (DoLS) for those people who needed them.
People’s nutritional and hydration needs were met. Menus were varied and people had choices at each meal as well as being offered alternatives if they changed their mind. The provider agreed to look into implementing communication aids such as photographs to help people make choices about what they would like to eat.
Person-centred care plans were in place and were regularly reviewed. The activities co-ordinator was in the process of producing a one-page background for each person to ensure there was a concentrated amount of person-centred information available to any new staff.
The activities co-ordinator had made a range of external links in the community and ensured there was a selection of activities available that people found meaningful and enjoyable.
There were a range of quality assurance, auditing processes and policies and procedures in place. Auditing had identified and led to improvements in service delivery. The manager, director and provider had produced and acted on an action plan to ensure the service maintained good standards of care at a time of managerial change.
Staff, people who used the service, relatives and external professionals spoke positively about the approachability of the new manager, who demonstrated a good knowledge of the service and people’s needs throughout the inspection.